| NPI | 1043295645 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NH 11405) |
| Additional Taxonomies | 171100000X Acupuncturist |
| Enumeration Date | 2005-12-07 |
| Last Update Date | 2021-01-19 |